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MONDAY, April 9, 2012 — If the tick-tock of your biological clock is getting more insistent, but you're not worried because you think you can always rely on in vitro fertilization (IVF) or other assisted reproductive technologies later on, you may want to to reconsider.

According to the American Society for Reproductive Medicine, roughly 20 percent of women now wait until they're 35 or older to try to get pregnant. There are several excellent reasons for this. For one, as of 2009, there are more women workers in the United States than male workers. And as more women work and enjoy fulfilling careers, they've been waiting longer to start families. But regardless of these social and demographic transformations, there's one immutable, biological fact that hasn't changed: A woman's fertility begins to decline in her late twenties to early thirties.

Unfortunately, not enough women appreciate the full reality of their ticking biological clock and are putting misplaced faith in the ability of fertility technologies to offset the challenges of trying to conceive at an advanced age. That's the finding of a new study conducted by doctors at the Yale Fertility Center and published in the journal Fertility and Sterility.

Doctors at the Yale center say they've seen a worrying trend among many of their older female patients, particularly women over 40. Women who've had trouble conceiving naturally seem to take it for granted they will easily get pregnant once they try assisted reproductive technology (ART), such as IVF. The problem is that while IVF has grown in popularity, it doesn't always work.

More IVF, Same Number of Babies

According to statistics from the Society for Assisted Reproductive Technology, between 2003 and 2009 the number of IVF cycles undergone by women 41 or older increased by 41 percent. Yet, as Yale Fertility Center director Pasquale Patrizio, MD, points out in a news release, greater numbers of IVF cycles haven't led to greater numbers of babies. "The number of IVF cycles resulting in pregnancy in women above age 42 mostly remained static at 9 percent in 2009," Dr. Patrizio said.

Then what's the source of this misplaced faith in IVF as a slam dunk? The Yale doctors place part of the blame on splashy media coverage of the growing ranks of celebrities (from Tina Fey — a daughter at 41 — to Kelly Preston — a son at 48) who've given birth after 40. Such news, they said in the release, makes it seem as if these women "effortlessly give birth at advanced ages." The truth, of course, is that we rarely know the full story about a celebrity's private path to pregnancy.

Regardless of the root of the confusion, Patrizio recognizes it can be extremely frustrating for otherwise healthy, happy, and successful women not to be able to conceive. “Their typical reaction is, what do you mean you cannot help me?" he admits in the release. "I am healthy, I exercise, and I cannot have my own baby?”

In fact, this painful confusion highlights the importance of a key recommendation of the Yale paper, which is that doctors must do a better job of educating women about ways they can preserve their chances of conceiving. For instance, one available technique is oocyte cryopreservation, in which a woman freezes eggs during her younger years and then essentially donates those eggs back to herself when she's older. While this process is recommended regularly for cancer patients, it could be used more frequently with healthy younger women — if they knew about it. As Patrizio says, "reproductive aging is irreversible" but "there are options to safeguard against the risk of future infertility."

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